Kim Shin Hye, Tan Keng Lu, Lee Sang Yeon, Kim Dae Woo, Shin Sue, Jin Hong-Ryul
Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, University Malaya, Kuala Lumpur, Malaysia.
Springerplus. 2016 Dec 30;5(1):2116. doi: 10.1186/s40064-016-3679-y. eCollection 2016.
This study investigated on bacterial contamination of the rhinoplasty field. The effect of preoperative chlorhexidine treatment on decreasing bacterial contamination in the rhinoplasty field is examined.
Thirty patients who underwent rhinoplasty were block randomized into a chlorhexidine, regular-soap, or control group comprising ten participants each. The chlorhexidine group was subjected to chlorhexidine showering, shampooing, and facial-cleansing 12 h prior to the operation. The regular-soap group was subjected to cleansing with regular soap, and the control group did not have any skin pretreatment. Bacterial cultures were done 12 h preoperatively from nasal cavity and perinasal skin, immediately preoperatively from perinasal skin and at 1 and 2 h intraoperatively from operation field. Culture results were compared between the three groups, according to operation time, or whether infection-prone procedure was performed.
The bacterial species and colony-forming unit numbers at preoperative nasal cavity and perinasal skin were similar. In all three groups, - was the most common bacteria found in the rhinoplasty field. The numbers of and decreased rapidly after preoperative chlorhexidine treatment. The infection-prone procedure was associated with increased bacterial numbers over time during the operation. In all three groups, there was no postoperative infection in a follow-up period of 6 months.
Rhinoplasty is confirmed as a clean contaminated operation with skin flora consistently found in the operation field. Chlorhexidine pretreatment in rhinoplasty patients has a tendency to decrease the numbers of and on the perinasal skin.
Randomized controlled trial, Level I.
本研究调查了隆鼻术术野的细菌污染情况。研究了术前洗必泰治疗对减少隆鼻术术野细菌污染的效果。
30例行隆鼻术的患者被随机分为洗必泰组、普通肥皂组和对照组，每组10人。洗必泰组在手术前12小时用洗必泰进行淋浴、洗头和面部清洁。普通肥皂组用普通肥皂进行清洁，对照组未进行任何皮肤预处理。术前12小时从鼻腔和鼻周皮肤进行细菌培养，术前即刻从鼻周皮肤进行细菌培养，术中1小时和2小时从术野进行细菌培养。根据手术时间或是否进行了易感染手术，比较三组的培养结果。
术前鼻腔和鼻周皮肤的细菌种类和菌落形成单位数量相似。在所有三组中，-是隆鼻术术野中最常见的细菌。术前洗必泰治疗后，-和-的数量迅速减少。易感染手术与手术过程中细菌数量随时间增加有关。在所有三组中，6个月的随访期内均无术后感染。
隆鼻术被确认为一种清洁-污染手术，术野中始终存在皮肤菌群。隆鼻术患者的洗必泰预处理有减少鼻周皮肤-和-数量的趋势。
随机对照试验，I级。
